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Autism Hurricane Response and Recovery Survey

Family Initiative is a nonprofit impact organization based in Southwest Florida to support children, teens, and young adults with autism and their families. Family Initiative is constantly working to better support the autism community, and is seeking input from families about their response and needs during emergencies such as hurricanes. If you feel like you can assist with this, please complete the survey. To learn more about Family Initiative, visit fi-florida.org.

1.Choose all of the following that heavily influence your decision to evacuate for a hurricane.

Wind speed that may damage my home or business.

Storm surge that may damage my home or business.

Flooding that may damage my home or business.

Loss of electricity following a storm.

Lack of reliable transportation.

Loss of internet service following a storm.

Loss of convenient access to food and drinkable water.

Inability to navigate roadways due to closure or obstruction.

Change of routine will adversely impact my child's behavior.

Desire to keep pets with the family.

Uncertainty about how my child's special needs will be addressed in a local emergency shelter.

Need for reliable medical response and access.

Other

Comments:

2.Check the categories of storms/hurricane for which you plan to evacuate in the future

Tropical Storm

Category 1

Category 2

Category 3

Category 4

Category 5

None of the above

3.If you DO NOT plan to evacuate, choose all reasons that contribute to why you will shelter in place at home.

I believe my home will not suffer wind damage.

I believe my home will not be effected by storm surge.

I believe my home will not be flooded.

I currently have 3 - 7 days of food and water for my family. (One gallon of water per person, per day.)

My family easily adjusts to emergency situations.

I do not anticipate a need for medical attention.

My family emergency fund will not currently cover evacuation costs of transportation, hotel, food, and other related expenses.

My family may not be able to return to the area due to road/bridge closures or other safety reasons.

Job requirements keep me in the area for response, recovery, or critical services (grocery store, construction, medical, first responder, etc.)

I want pets to stay with the family and do not have a viable option outside my home.

Other

Comment:

4.What are your current evacuation plans for a major hurricane?

Friend's Home

Relative's Home

Hotel/Home Rental/Other paid option

Emergency Evacuation Shelter

Within Lee County

Friend's Home

Relative's Home

Hotel/Home Rental/Other paid option

Emergency Evacuation Shelter

Within SW Florida

Friend's Home

Relative's Home

Hotel/Home Rental/Other paid option

Emergency Evacuation Shelter

Within Florida

Friend's Home

Relative's Home

Hotel/Home Rental/Other paid option

Emergency Evacuation Shelter

Out of State

Friend's Home

Relative's Home

Hotel/Home Rental/Other paid option

Emergency Evacuation Shelter

Comment:

5.How do you receive/look for the most reliable news on tropical weather/hurricanes and possible evacuation orders? Choose all that apply.

Local TV news

The Weather Channel

AM/FM Radio

Online Radio

Weather app

Social Media

Online news sources

Friends

Employer

Other

Comment:

6.Which Lee County Emergency Resources are you familiar with? Check all that apply.

Hurricane Preparedness Videos

All Hazards Guide

Special Needs Program

Public Shelters

Pet-Friendly Shelters

Emergency Preparedness Guides

Evacuation zones, routes, transportation, checklist

Flood Zone Maps

None of the above

7.Check all areas in which your family is currently prepared.

I have the AlertLee app to receive emergency alerts and warnings.

I have the Lee Prepares Disaster Preparedness app on my phone.

If eligible, I am registered for the Lee County Special Needs Program.

I know my home and work Flood Zone and Evacuation Zone.

My family has at least 3 days of food and water on hand right now.

If applicable, my family has at least two weeks of prescribed medications on hand.

I have cash to purchase food, water, gas, or medical supplies for at least one week after a storm.

I have a working generator and know how to safely use it.

I have a solar charging device for my phone and other electronics.

My families important documents are in a secure waterproof location or have been securely saved to a USB drive or cloud location. (Home insurance policy, medical cards, marriage and birth certificates, social security cards, pet vaccination records, will and estate planning documents.)

Other (Please specify)

None of the above

Comment:

8.After a hurricane, what are the most urgent PERSONAL needs your family will have that you CANNOT MEET. Check all that apply.

Food for at least 3 days.

Special dietary needs. (Specify in "other" section below.)

Drinking water for at least 3 days. (1 gallon per person, per day.)

Water for bathing and washing for at least 3 days.

Daily or weekly laundry.

Access to a solar charger or charging station for electronic devices.

Batteries for electronic devices.

A safe place to sleep.

Cooling location during the day.

Transportation to medical appointments.

Personal hygiene items. (Specify unmet needs in "other" section below.) (Soap, deodorant, shampoo, feminine products, adult diapers, child diapers, wipes, disposable bed pads, toilet paper.)

Childcare while at work.

Assistance with pets. (non-poisonous, non-venomous)

Prevention of elopement.

Other (please specify)

9.After a hurricane, what are the most urgent RECOVERY needs that you CANNOT meet.

Assistance with FEMA claim.

Assistance with home or auto insurance claims.

Assistance with medical claims.

Debris clean-up.

Removal of storm shutters.

Repair of damaged home items.

Repair of items to prevent elopement. (Specify in "other" option below.) (Gates, latches, fences)

Other (please specify)

10.What are the most critical services your child is currently receiving from Family Initiative or other provider that you will need within one week after a hurricane.

ABA therapy

Occupational Therapy

Social Skills Group

Sensory Support/Therapy

Not currently receiving services from Family Initiative.

Not currently receiving any services noted above from other provider.

Other (please specify)

11.What skills or abilities can you volunteer after a hurricane to assist the Family Initiative/autistic community?

Distribution of food, water, and supplies at a designated location.

Computer skills to assist with FEMA or insurance claims.

Debris clean-up

Handyman skills for repairs

Cleaning

Cooking

None of the above

Other (please specify)

12.Do you follow Lee County Public Safety on social media? Check all that apply.

Facebook

Twitter

Instagram

LinkedIn

None of the above

13.Do you follow Lee County Government on social media? Check all that apply.

Facebook

Twitter

Instagram

LinkedIn

None of the above

14.How many people are in your immediate family? (# of people reflected in your answers)

1

8

15

15.How many pets do you have?

0

1

2

3

4 +

Dogs

0

1

2

3

4 +

Cats

0

1

2

3

4 +

Other

0

1

2

3

4 +

Other (please specify)

*16.What county do you live in?(Required.)

Charlotte

Collier

Glades

Hendry

Lee

Other (please specify)

17.What is your name?

First Name

Last Name

18.What is your email address?

19.What is the address where you currently live?

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Phone Number with Area Code

20.May we contact you again in the future? Choose preferred methods of contact.

Email

Phone

Text

U.S. Mail

Please do not contact me in the future.

100%

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